إيه المقصود بـEndoscopic submucosal dissection (ESD)

🔍 Endoscopic submucosal dissection (ESD) is a well-established, minimally invasive endoscopic technique for resecting precancerous lesions and early stage cancers arising from the gastrointestinal (GI) tract.

🎯 Key features of ESD:

📌 Indication: Primarily employed for adenomas with high dysplasia or suspected early invasive carcinoma, aiming for complete (en bloc) resection to minimize recurrence risk.

🛠️ Technique: Utilizes an endoscope to access the GI tract and specialized instruments to dissect the lesion from the deeper layers of the GI wall after submucosal injection for lift creation.

💡 Benefits: Offers minimally invasive approach compared to traditional surgery, resulting in shorter hospitalization, faster recovery, and minimal scarring.

🔄 Procedural steps (simplified):

1. Submucosal Injection: Creates a fluid cushion beneath the lesion for easier maneuverability and separation from surrounding tissues.
2. Circumferential Incision: The endoscope is used to precisely incise around the base of the lesion.
3. Meticulous Dissection: Careful dissection with specialized instruments separates the lesion from the deeper GI wall.
4. En Bloc Resection: The resected lesion is removed entirely through the endoscope.
5. Hemostasis: Bleeding vessels are identified and coagulated using electrocautery to prevent complications.

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ICU Nutrition by Dr Moataz

#ICU

#Nutrition

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كلّ يومٍ هناك فرصة جيدة ومساحة واسعة لعُمران الجَنّةِ مِن هُنا، إن صَدَقنا القَصد، وأحسَنّا الخُطىٰ، وأخلَصنا السِّرّ للّه..

-قصي عاصم.




لا تنسوا الصلاة على النبي والكهف والدعاء،
ولا تنسونا..

قال أبي سعيد الخدري رضي الله عنه: قال رسول الله صلى الله عليه وسلم: من قرأ سورة الكهف في يوم الجمعة، أضاء له من النور ما بين الجمعتين. رواه الحاكم والبيهقي وصححه الألباني.

﴿ إِنَّ اللَّهَ وَمَلَائِكَتَهُ يُصَلُّونَ عَلَى النَّبِيِّ ۚ يَا أَيُّهَا الَّذِينَ آمَنُوا صَلُّوا عَلَيْهِ وَسَلِّمُوا تَسْلِيمًا﴾
[ الأحزاب: 56]

✈️🇬🇧

▶️ Watch this video https://www.facebook.com/share/p/DPZBKbKEZojPbv8x/?mibextid=WC7FNe

تفريغ د عبد المتعال فودة CNS

Therapy of epilepsy
Part2: 1st generation of antiepileptic drugs

By Dr Maymounah
"من إستفاد فلا ينسى الشهيد أبو آية بدعوة صادقة"

⚠️⚠️ملاحظة: واجهة صورة الpdf مكتوب بيها part3: 2nd generation سهواً انما هيه part2: 1st generation اتمنى الانتباه وشكراً💙💙

#Pharmacy

#Neurology

#Tafreghat
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إيه دور Empagliflozin في علاج مرضى CKD؟

🌟 Empagliflozin: A Potential Therapeutic Option for Chronic Kidney Disease (CKD)

Recent clinical trials have shed light on the potential benefits of empagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, for patients with chronic kidney disease (CKD).

🔍 Emerging Evidence: The EMPA-KIDNEY trial demonstrated that empagliflozin therapy, compared to placebo, may significantly reduce the risk of a composite endpoint of kidney disease progression (including end-stage renal disease or sustained eGFR decline) or cardiovascular death in a broad population of CKD patients.

🔬 Mechanism of Action: Empagliflozin primarily functions by lowering blood sugar levels by promoting urinary sugar excretion. However, in CKD, it may also offer renoprotective effects by reducing intraglomerular pressure and inflammation.

💊 Potential Benefits: Clinical data suggests empagliflozin may slow CKD progression, decrease the need for dialysis, and reduce the risk of cardiovascular complications in some patients.
Additionally, research indicates a potential for decreased overall hospitalization rates.

📋 Individualized Treatment Considerations: It's important to note that empagliflozin is not universally recommended for all CKD patients.
Comorbidities, kidney function stage, and other medications should be considered when evaluating a patient's suitability for this therapy.

🔍 In Conclusion: Empagliflozin represents a promising therapeutic approach for specific CKD patient populations.
However, further research is needed to fully define its role in CKD management.

🌐 Reference ➡️ Pubmed

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تجميعة سريعة لبعض البوستات المهمة
سواء تخص الجايدلاينز أو القنوات أو المعادلات الأجنبية:
.
مواقع الجايدلاينز:
الموقع ده تقريبا مجمع كل الجايدلاينز .. مجرد تبحث في خانة البحث من فوق
https://www.medscape.co.uk/primary-care-guidelines
.
دا نفس الحوار هتلاقي كل الجايدلاينز تقريبا عليه (مجرد فقط ابحث)
https://www.guidelinecentral.com/guidelines/?fbclid=IwZXh0bgNhZW0CMTAAAR0eDbaOrTuY5oJLRltZOBlKL02N-79gUzX_72uQ8RitSAdeT7rBizDUQL8_aem_AcnV1RpZTpqzx1ekuGxbf0b0-yr-CnsdsZN2bEq-xn-mjjIwRCMnktGPVUf2CPXZNhNG45y_POSf9ZOu8Ysw-d1j
.
مواقع الجايدلانز في تخصصات الباطنة
https://www.facebook.com/AAlskary/posts/pfbid04RfnZHUhYY4BxdPzW1z1SCeHhooyYYaEZkknbKjhFFzcGvZt9B8y92xtkcruPQ6dl
.
بعض مواقع الجايدلاينز لتخصص الأطفال:
https://www.facebook.com/AAlskary/posts/pfbid02ue6L1xSs4uSZjXkrex1h19WA764TMso9X71f2HYtRCSEuksepENnbCcbg7oxqpj8l
.
مصادر مذاكرة وقنوات للمتخصصين في القلب (والباطنة)
https://www.facebook.com/AAlskary/posts/pfbid023ic3idABCvkJzUsqR7VXDuVasNWBkep6JQ7iadJZ6cKnFayDyeay7TBhk1Z9mccGl
.
المعادلات MRCP & USMLE
https://www.facebook.com/AAlskary/posts/pfbid02j74afGLvgVMGgFBpzkntwUgUo58fGCTcY7gNmnWtJAFRvg2X1E9Hm4P9xHcA3g37l
.
https://www.facebook.com/AAlskary/posts/pfbid07P28BGf69xjAtwkerUPzhzqP3aqjBgGRTXB7gWxGNpEHALW14YobNhoYuCgVRV1Jl
.
القنوات:
.
https://www.facebook.com/AAlskary/posts/pfbid02CM7d7T7Hvd4HzRi2CrNhdyaZaAqDdLjxhcwxfNNCXGrz3kuCyPSQxqHnT3dQaXTgl
.
https://www.facebook.com/permalink.php?story_fbid=pfbid0ohKMyMeXe38pV7Ty3Ts1sKQiUHANaG32TXUy7LU4ahdyis9L3wegff3C4ByXaTtSl&id=100027854642044

كل ما تريد معرفته عن
Bone Marrow Transplant (BMT)

📋 Definition:

* BMT is a potentially curative treatment for various hematologic malignancies and disorders.
* It involves replacing diseased or nonfunctional bone marrow with healthy stem cells, enabling the patient to produce healthy blood cells.


🔬 Applications:

* BMT is considered for a range of conditions, including:
* Acute leukemias
* Lymphomas
* Myeloma
* Aplastic anemia
* Sickle cell disease

🩸Types of BMT:

* Autologous BMT: Utilizes the patient's own stem cells collected prior to conditioning.
* Allogeneic BMT: Employs stem cells from a matched donor, offering a graft-versus-tumor (GVT) effect in malignancies.

🥼 BMT Process:

1. Conditioning Regimen: High-dose chemotherapy and/or radiation therapy eradicate residual malignant cells and immunosuppress the recipient to prepare for engraftment.
2. Stem Cell Collection:
* Autologous: Bone marrow aspiration or peripheral blood stem cell (PBSC) apheresis.
* Allogeneic: PBSC apheresis from a matched donor (HLA-matched sibling or unrelated donor registry).
3. Stem Cell Infusion: Administered intravenously through a central venous catheter.
4. Engraftment: Period where infused stem cells migrate to the bone marrow and begin producing new blood cells.
5. Post-Transplant Care: Close monitoring for engraftment, infections, and graft-versus-host disease (GVHD).

⚕️ Considerations:

* BMT is a complex procedure with significant potential for complications.
* Patient selection requires careful evaluation of disease status, comorbidities, and performance status.
* Supportive care plays a vital role throughout the transplant journey.


🧠 Conclusion:

BMT remains a powerful therapeutic tool offering the potential for cure in various hematologic conditions. However, thorough patient selection, meticulous management, and a multidisciplinary approach are crucial for successful outcomes.

🌐 Reference ➡️ Mayo Clinic

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GLP-1 مقارنة
by Dr Mohamed Adel

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